Each year approximately 15 million babies are born prematurely. This is more than one in 10 of all babies born around the world. All newborns are vulnerable, but preterm babies are acutely so. Many require special care and treatment simply to remain alive. Newborn deaths — those in the first month of life — account for 40 per cent of all deaths among children under five years of age. Prematurity is the world’s single biggest cause of newborn death, and the second leading cause of all child deaths, after pneumonia. Many of the preterm babies who survive face a lifetime of disability. Urgent action is needed to address those babies born too soon, especially as preterm birth rates are increasing each year.
Joy Lawn is a paediatrician and perinatal epidemiologist. She has over 20 years’ experience in newborn health with a specific focus on Africa, including four years as a lecturer and neonatalogist in Ghana. She shifted to public health and global estimation whilst at the WHO Collaborating Center, CDC Atlanta, USA (1998-2001), and then at the Institute of Child Health, London, UK (2001-2004), completing a Masters of Public Health at Emory University, Atlanta and PhD at University College London. In March 2013, she was appointed Professor of Maternal, Reproductive and Child Health and Director of MARCH Centre at the London School of Hygiene and Tropical Medicine. For over ten years she worked for Save the Children’s Saving Newborn Lives program, funded by the Bill & Melinda Gates Foundation. Most recently she was their Director of Global Evidence and Policy, and worked with governments and partners to integrate, scale up and evaluate newborn care. In 2011 she was appointed as the UK AID (DfID)’s Senior Research Fellow for newborn health (part-time).
Since 2004, Joy has coordinated the United Nation’s Child Health Epidemiology Reference Group’s (CHERG) Neonatal Team and developed the first cause-of-death estimates for 4 million neonatal deaths each year, published in 2005 in The Lancet Neonatal series and WHO’s World Health Report. She also co-led The Lancet Stillbirth series in 2011 including developing WHO’s first national estimates of stillbirth rates, highlighting 2.6 million stillbirths worldwide. In 2011 she coordinated the first ever national estimates for preterm birth, published in The Lancet and co-led the team for Born Too Soon: The Global Action Report for Preterm Birth, with over 50 partner agencies to outline the data and actions to address 15 million preterm births, garnering major media attention. She also coordinated the GBD Expert team for neonatal and congenital conditions and is on the scientific committee of Countdown to 2015. Joy has published over 100 peer reviewed papers and led or contributed to several high profile publications highlighting global estimates and linked solutions that have resulted in wide-scale change in low income countries. She is also a founding Board Member of Powerfree Education and Technology, a South African not-for-profit organization developing and testing innovative technology to improve maternal, newborn and child survival. Joy is the 2013 recipient of the PGPR Award for Outstanding Contributions to Global Child Health, particularly for her leadership and mentoring teams for newborn survival.
A presentation given by Joy called Born Too Soon, The Global Action Report on Preterm Birth, gives more details on the current situation. Some key messages include the fact that preterm birth is the second leading cause of death for children under 5 years, after pneumonia and that 1.1 million babies die directly from complications of preterm birth.
Each year, more than 1 in 10 of the world’s babies are born preterm, resulting in 15 million babies born too soon. Actions to improve care would save hundreds of thousands of babies born too soon from death and disability. Accelerated prevention requires urgent research breakthroughs. Recent advancements, details of how the situation has moved forward and what has been achieved for preterm birth are described in an article by Kinney et al. (2012).
An analysis of donor-reported data between 2002 and 2010 found that donor attention to newborn survival has increased since 2002, but it appears unlikely that donor aid is commensurate with the 3.0 million newborn deaths and 2.7 million stillbirths each year. The full report can be downloaded here.
Country data and rankings for newborn survival data can be sourced through the Healthy Newborn Network. It is linked to the A Decade of Change for Newborn Survival supplement, which presents a comprehensive multi-country analysis of the changes in newborn care and survival from 2000 to 2010 and 5 detailed country case studies in order to better understand the process of taking solutions to scale and how to accelerate progress for reduction of mortality and morbidity.
Born Too Soon is a global action report focused on preterm birth. It brings together the first-ever national estimates on preterm births. It notes that there are currently 15 million babies born prior to 37 weeks every year and that the rates are rising. A preterm birth is now the second leading cause of under-five mortality, after pneumonia, resulting in 1.1 million deaths every year.
In May 2012 more than 70 participants from 30 countries gathered in Geneva at the World Health Assembly to discuss the new evidence on preterm birth that the report presents. The Breakfast Briefing attracted a number of ministers and senior national policymakers to learn about the new evidence.